When Is Tooth Extraction Necessary?

If you ask the Tooth Fairy, she’d give you 20 baby teeth reasons to pull a tooth. But when it comes to adult teeth, extraction is a serious medical procedure. It shouldn’t be taken lightly, and getting good information about tooth extraction shouldn’t be like … pulling teeth.

Before your dental appointment or consultation, sink your teeth into these common reasons an extraction may be necessary.

If it stanks, it may be time to yank

In all seriousness, extraction is not a cure for halitosis. However, when a tooth is badly infected it can cause an unpleasant odor, and that could mean it’s time to get pulled. Whether extraction is recommended will depend on the severity of the infection, also known as an abscess.

There are three types of abscess:

1. Gingival abscess—This is an infection of the gum line that can often can be treated. However, if left alone for too long, the infection can spread to the tooth and cause serious periodontal damage.
2. Periodontal abscess—This is a deeper infection of the gums and can easily spread to the jaw bone and surrounding tissue.
3. Periapical abscess—This is an infection inside the pulp of the tooth, where it can enter the bloodstream and cause more serious damage.

As you may have guessed, the last two types of infection can be the most serious. They can lead to facial swelling and radiating pain that goes from the tooth to the ears, temples and cheeks. They are the types of infections that often call for tooth extraction.

Filled with trauma

Fillers now include materials such as gold, silver amalgam, porcelain and composite resin. Often, they can save the day for a tooth experiencing decay. However, for a tooth that has gone through a major traumatic incident—like getting broken or cracked in an accident—it may be better off gone than cleaned and filled.

Fillers and fluoride can only do so much. For teeth with multiple cracks and breaking points, it’s a matter of time before decay sinks in and causes additional dental and health problems. If your dentist is recommending extraction, they aren’t being extreme, they are just getting real.

One tooth too many

Overcrowding is another common reason dentists and orthodontists will extract teeth. Not all adult teeth come in at the same time. And, not all adult teeth grow precisely in the spot that was designed for it. In addition, some teeth grow too large. All this means that your mouth can develop what dentists call “impacted” teeth. Impacted teeth often grow into the wrong position, causing them to be useless and sometimes painful.

When getting braces, it’s very common to have your wisdom teeth removed to make proper space for teeth that are turned or otherwise out of position. According to the American Association of Oral and Maxillofacial Surgeons, about 85% of the population has wisdom teeth extracted.

The tooth fairy unchained

There is a special kind of impacted tooth commonly—and mistakenly—called a third set of teeth. Occasionally, folks will have an additional adult tooth try to make its way to the surface. It’s called hyperdontia or supernumerary teeth. Supernumerary teeth can be in the form of bicuspids, canine or molars, but are most often not fully formed and peg-like.

A person with hyperdontia can go a lifetime without issues. However, sometimes the supernumerary tooth can erupt and cause damage to the gumline or start to wedge between and misalign the existing adult teeth. In these cases, dentists will recommend an extraction.

Alternatives to extraction

Although common, extractions are serious medical procedures. That’s why root canal is often attempted first. During a root canal, the infected pulp (the interior of a tooth) is removed since it is not needed by a fully formed tooth. The inside of the tooth is then disinfected and filled and with a rubber-like material called gutta-percha.

The final step is to restore the tooth with a protective crown or filling. In a matter of hours, the patient can start using the tooth as they normally would.

According to the American Association of Endodontists, millions of teeth are saved this way each year.

The final alternative to extraction is proper dental hygiene and regular dental checkups. Not all extractions can be avoided, but many can when you brush at least twice and floss at least once daily. That’s because you are staying on top of the bacterial buildup that causes decay. Meanwhile, regular visits to the dentist where X-rays can be taken and deeper cleanings are done up the odds of catching cavities and other dental issues that could lead to the need for extraction.

An apple a day may keep the doctor away, but dental exams as part of your regular healthcare can help your teeth stay—and make that apple go down the easy way. Take the first bite and schedule an appointment today.